Avoid using NSAIDs—non-prescription pain killers like ibuprofen—if you want to build muscle and perform at your best. NSAIDs are amazingly popular among athletes and recreational trainees alike, which is very concerning because recent research shows they really aren’t good for you!
First, a recent study of trained athletes tested what would happen during an exhaustive exercise trial if the athletes took 400 mg of ibuprofen—that’s two capsules of the standard 200 mg ibuprofen dose, so it’s not that much. Results showed there was significant evidence of intestinal injury after the exercise trial on ibuprofen. There was also loss of gut barrier integrity, which increases risk of infection.
The short-term effect of intestinal injury due to NSAID use with exercise is leakage from the gut, increased inflammation in the body, and lower absorption of nutrients. It could compromise athletic performance and delay your recovery post-workout. In the long run, taking an NSAID and training hard could lead to permanent gut damage, an inflammatory status in the body, nutrient deficiencies and increased risk of cardiovascular events.
Second, emerging evidence suggests NSAIDs compromise long-term muscle development. They also may inhibit complete regeneration of tendons and connective tissue. Two recent reviews show that NSAIDs block enzymes in the body that are involved in protein synthesis. This effect is thought to inhibit the activation and growth of satellite cells in the muscle (muscle stem cells) that you must target for long-term muscle growth.
By looking at what happens following a tendon injury, it’s possible to see how NSAIDs can stall muscle growth. It works like this: After a tendon injury, there is inflammation and increased blood flow to the injury site. NSAIDs can decrease the swelling and aid in removal of adhesions to the tendon. Short term, NSAIDs get rid of pain and aid the healing process, but in the long run the satellite cells response is blunted, inhibiting complete recovery.
A similar effect appears to influence hypertrophy. Animal studies show muscle growth is 50 to 75 percent lower following NSAID use. Human studies are contradictory in deconditioned people who start training for the first time. Shorter term NSAID use doesn’t appear to get in the way of gaining strength, but with what we know about how these drugs cause gut damage, it’s ideal to avoid them if at all possible.
Take away the following points:
• Ibuprofen and NSAIDs should be avoided when exercising because they can cause damage to the gut and impair nutrient absorption.
• NSAIDs are not benign. With exercise they may increase risk of cardiovascular adverse events, and they have been shown to get in the way of long-term tendon and muscle repair.
• NSAIDs appear to impair long-term muscle growth due to how they affect satellite cell activation.
Wijck, K., Lenaerts, K., et al. Medicine and Science in Sports and Exercise. 2012. 44(12), 2257-2262.
Schoenfeld, Brad. The Use of Nonsteroidal Anti-Inflammatory Drugs for Exercise-Induced Muscle Damage. Sports Medicine. 2012. 42(12), 1017-1028.